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 ezema or Drug allergy  

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A 37 yo woman come to the physician because of an itchy rash over her trunk for 2 weeks. She has not had fever, chills, shortness of breath, chest pain or GI symptom. She has h/o recurrent urinary tract infections and have been taking Trime-Sulfa prophylaxis for the past year. She is in mild distress. Her temparature is 37.5, BP 96/62, PR 78, RR 14. Examination shows a maculopapular erythematous rash over the trunk. Lab show
Leukocyte : 10,000
- segmented neutrophils 72%
- bands 1%
- eosinophils 15%
- lymphocytes 4%
- monocytes 8%
- BUN 12 - Creatinin 0.9
- WBC 2 -RBC 2
Which of the following is the most likely cause of these findings
A.. Eczema
B. Medication adverse effect
C. Stap skin infection
D. Step skin infection
E. Urinary tract infection


B. Medication adverse effect


b-due to TMp-Sulfa


The problem is pt has been on sulfa for a year without any problem.So Eczema is a suspect.
but i still prefer Sulfa reaction bc the rash can BEGIN even after u stop the drung


B - Sulfa reaction nod

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